Background: Considering the challenges of cancer service delivery in NS, the growing demand to provide efficient, effective and sustainable cancer services to patients and families while improving outcomes, and the restructuring of health care within the province, the Department of Health and Wellness has directed Cancer Care Nova Scotia to engage third party experts to work with system leaders to review the current status of the cancer care delivery system and supports within Nova Scotia and to provide recommendations on a model for the provincial delivery of cancer care. This model will consider clinical, academic and administrative leadership models, accountability frameworks, governance, monitoring and evaluation as part of service delivery. It will address the roles of health care professionals as well as the roles of Cancer Care Nova Scotia and the Nova Scotia Breast Screening Program as provincial programs of the Department of Health and Wellness.

Purpose: To vet the report from expert consultants and make recommendations regarding an optimal provincial approach to cancer service delivery, including a high level implementation strategy; and to provide recommendations to the Chief of Programs, Department of Health and Wellness on the model.

Role: The Steering Committee will provide overall direction to the development of the optimal provincial approach for cancer service delivery model (screening and early detection through to survivorship and palliative care) and a high level implementation strategy.

The Steering Committee will: • Provide advice/guidance to the Project team regarding all plans and key deliverables, considering feasibility, appropriateness, sustainability for CCNS, DHAs, DHW, patients and families, and other stakeholders using the DHW quality framework and the quality principles guiding the restructuring of the provincial health system. • Assure that affected stakeholders (cancer patients / survivors/ family members and others) are appropriately involved and consulted. • Monitor Project Team’s progress against major milestones • Review and comment on progress reports • Review final report and recommendations, noting any gaps and providing feedback to project team • Provide recommendations to Chief of Programs, Department of Health and Wellness, based on the expert report, regarding an optimal provincial approach to cancer service delivery, including rationale for the recommendations.

Membership: Chaired by three leaders representing: Department of Health and Wellness, clinical, and administrative leadership.

Process, meetings, reporting• An orientation meeting will be scheduled for early September, with meetings held monthly or at the call of the Chair • The Chair of the Project Team will provide regular updates to the Steering Committee, seeking advice and guidance as necessary • Decision-making (consensus, voting, formal/informal)

A consensus model of decision-making will be used whenever possible. The consensus model will include the following parameters: • Are the right people in the room? • Have all members had an opportunity to discuss the issue? • Do members understand the decision to be made? • Can members live with the decision? • Can members defend the decision? • Everyone can and will support the decision outside the room

If consensus is not possible, aiming for an 80:20 agreement. When this is not possible, a decision will be at the discretion of the Chair with dissenting opinions noted.

Resources• Funding will be provided by Cancer Care Nova Scotia to cover costs associated with teleconferences, travel to face-to-face meetings and reimbursement of FFS physicians at the negotiated rate. • A commitment to using distance technology whenever possible and appropriate

Time commitment: monthly meetings (four or five meetings in total), September – December 2014